The use of Plan-Do-Study-Act (PDSA) cycle in perfection of fracture liaison service work
https://doi.org/10.14341/osteo10272
Abstract
Background: Secondary fracture prevention services (FLS) have been established around the world during several last years. However, due to the differences of medical care organization in different regions, it is difficult to offer a unified approach of the structure and separate components of such services, which could be used everywhere. It is recommended to apply the Plan-Do-Study-Act (PDSA) cycle to evaluate the FLS in the institution.
Aim: To study the application of the PDSA cycle in the optimization of FLS working in Yaroslavl.
Materials and methods: We evaluated the effectiveness of FLS organization which was created in the Emergency medical care hospital n.a. N. V. Solovyov at two stages of its development: at the first stage we worked using the principle «by referral of a traumatologist», at the second stage we used a dedicated coordinator. We used the questionnaire «Best Practice framework» for assessment. We also used PDSA cycle to analyze and evaluate the effectiveness of FLS organization.
Results: At the stage «by referral of a traumatologist» we revealed problems with patients’ identification, timing of assessment after a fracture, low frequency of initiation of osteoporosis therapy, lack of a falls prevention system and problems with a database. After the analysis and revealing shortcomings we’ve made several changes in the organization of our FLS. First of all we introduced a dedicated coordinator-nurse in the staff of FLS.The following analysis showed that significant improvements had been made in all revealed directions. The following application of the PDSA cycle again identified several issues of FLS organization requiring improvement.
Conclusion: Thus, the use of the PDSA cycle during the organization of FLS is a tool of effective control and establishment of an effective care system for patients with low-energy fractures.
About the Authors
Ksenia Y. Belova
Yaroslavl State Medical University
Russian Federation
Russian Federation
MD, PhD
Olga B. Ershova
Yaroslavl State Medical University
Russian Federation
Russian Federation
MD, PhD, Professor
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For citations:
Belova K.Y., Ershova O.B. The use of Plan-Do-Study-Act (PDSA) cycle in perfection of fracture liaison service work. Osteoporosis and Bone Diseases. 2019;22(2):4-13. (In Russ.) https://doi.org/10.14341/osteo10272
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